LAPAROSCOPIC MANAGEMENT OF ADNEXAL ABSCESSES - CONSEQUENCES FOR FERTILITY

Objective: To study fertility of patients with adnexal abscesses treat ed by laparoscopy, antibiotic therapy, and second-look laparoscopy. De sign: A retrospective clinical study. Setting: Department of Obstetric s Gynecology and Reproductive Medicine, University of Auvergne, Univer sity Hospital of Clermont Ferrand, France, Patient(s): Thirty-nine pat ients treated for adnexal abscesses between January 1983 and December 1992. Intervention(s): Laparascopic drainage of adnexal abscesses was performed in all patients; 35 patients underwent a second laparoscopy 3 to 6 months later. Main Outcome Measure(s): Immediate and long-term clinical results, anatomical data obtained at second-look. laparoscopy , spontaneous fertility. Result(s): No immediate reoperation was neces sary within the first 2 months after the initial laparoscopic surgery. At second-look laparoscopy, an adhesiolysis was necessary in all case s. A distal tuboplasty was performed in 17 patients and 6 patients wer e referred to IVF-ET. Subsequently, 12 of 19 patients not using any co ntraception obtained a spontaneous intrauterine pregnancy (63%). Concl usion(s): This study confirms that laparoscopic surgery is a safe and efficient technique for treating adnexal abscesses. Anatomical results observed at second-look laparoscopy suggest that this second surgical step is essential for patients desiring future pregnancy.